Bills may pave way to expand Medicaid

After Kasich proposal failed to make budget, measures would take indirect route

6/13/2013

BY JIM PROVANCE BLADE COLUMBUS BUREAU CHIEF

■ Targets $1.4 billion income tax cuts to small business owners.■ Expands reasons that local governments may meet in closed executive session to include requests for economic development incentives.■ Adds $717 million in basic education subsides over the next two years above what K-12 schools have received in the current budget.■ Prohibits publicly funded hospitals from entering into emergency care transfer agreements that abortion clinics need to keep their licenses.■ Allows state regulators to mandate that casinos, racetrack slots parlors, and sweepstakes cafes install equipment to capture and store digital facial images of customers.■ Provides a sales-tax exemption for the Toledo Mud Hens organization and forgives a past-due tax bill of $553,389.■ Places Planned Parenthood at the end of the line when it comes to distributing federal family-planning dollars.■ Expands eligibility for taxpayer-funded vouchers for students to attend private or religious schools by allowing current voucher recipients to continue to receive them at reduced rates if their parents’ income rises to as much as 400 percent of the federal poverty level.■ Opens the door for some noninterstate, four-lane divided highways to join formal interstates with a new maximum speed limit of 70 mph.■ Provides $600,000 to implement a new forensic research and training center at Bowling Green State University next year in anticipation of construction of a new attorney general crime lab on campus.■ Revises funding for public universities and colleges away from enrollment counts toward rewarding them for degree-completion rates and success in keeping graduates in Ohio.■ Authorizes enforcement of liquor control laws over food items containing 0.5 percent alcohol, a move targeting things like flavored gelatin shots.

COLUMBUS — The Medicaid dance continued on Thursday in the Ohio General Assembly with the introduction of a pair of bills that may or may not serve as a path to expansion of the program.

Meanwhile, a six-member conference committee charged with fashioning a compromise between differing Senate and House versions of a two-year budget abruptly canceled its first meeting. It was supposed to get updated revenue and spending projections from Gov. John Kasich’s budget director to see if lawmakers might have more money to play with.

It will now meet Tuesday.

The Republican governor broke with the conservative element of his party to propose expansion of eligibility for Medicaid under the federal health-care law, providing coverage in the proposed budget for those earning as much as 38 percent over the federal poverty level. That’s roughly $32,000 a year for a family of four.

The expansion was expected to cover an additional 275,000 Ohioans, including an estimated 18,356 in Lucas County, over the next two years. The federal government has promised $13 billion in subsidies to Ohio over seven years, covering all the costs for three years, then gradually dropping to 90 percent.

But neither the House nor Senate-passed versions of the $61.7 billion budget contains the expansion. Identical bills introduced in both chambers Thursday wade into Medicaid waters independently of the budget, but they ignore expansion in favor of cost-containment and work-development initiatives.

“We have been able since 1965 to cover additional lives in Medicaid, but we have not done so because it is not affordable,” said Sen. David Burke (R., Marysville), who sponsored the Senate bill with Sen. Capri Cafaro (D., Hubbard).

“I think that before we have that discussion, we have to make it affordable,” he said. “The first part of the conversation has to be bending that cost curve.”

The bill would tie growth in the Medicaid program to the medical component of the cost-of-living index. It would require a new 10-member, legislative Joint Medicaid Oversight Committee to work to keep costs within those goals.

Among the bill’s proposed reforms are removal of Medicaid eligibility requirements seen as barriers to employment and employer-provided health insurance, reduced rehospitalizations, and better information for recipients about Medicaid services.

“This legislation represents a first step toward providing health coverage to more Ohioans, especially the working poor and veterans,” said Ms. Cafaro, an expansion supporter.

Hearings will also begin next week on a separate compromise proposed by Rep. Barbara Sears (R., Monclova) that would link some similar initiatives with the expansion. Like Mr. Kasich, she believes the expansion makes financial sense for the state. She said she hopes the latest bills will come full circle back to expansion. “I believe the expansion is in there at some point,” the No. 3 House Republican said. “It needs to be.”